结直肠癌根治术后舒芬太尼、氟比洛芬酯联合右美托咪定静脉自控镇痛的有效性和安全性研究  

Efficacy and Safety of Sufentanil Combined with Flurbiprofen Axetil and Dexmedetomidine for Patient-controlled Intravenous Analgesia in Patients after Radical Resection of Colorectal Cancer

作　　者：郑艳芹 刘坤[1] 解传奇[1] ZHENG Yan-qin;LIU Kun;XIE Chuan-qi(The First People's Hospital of Shangqiu City,Shangqiu,Henan 476000)

机构地区：[1]商丘市第一人民医院,河南商丘476000

出　　处：《中国肛肠病杂志》2023年第5期25-27,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨舒芬太尼、氟比洛芬酯联合右美托咪定用于结直肠癌根治术后病人静脉自控镇痛(PCIA)的有效性和安全性。方法:将2019年1月至2022年9月于我院择期行开腹结直肠癌根治术的80例患者按照随机数字表法分为观察组和对照组,各40例。对照组术后应用舒芬太尼和氟比洛芬酯进行PCIA,观察组术后应用舒芬太尼、氟比洛芬酯和右美托咪定进行PCIA。比较2组患者术后48 h内不同时间点咳嗽时疼痛视觉模拟评分(VAS)、Ramsay镇静评分,术后24 h内PCIA泵有效按压次数、舒芬太尼用量,术后48 h内不良反应发生情况。结果:观察组患者术后4 h、8 h、12 h、24 h咳嗽时VAS评分明显低于对照组(P<0.05),术后48 h时2组比较差异无统计学意义(P>0.05)。观察组患者术后4 h、8 h Ramsay镇静评分高于对照组(P<0.05),术后12 h、24 h、48 h时2组比较差异无统计学意义(P>0.05)。术后24 h内观察组PCIA泵有效按压次数及舒芬太尼用量均明显少于对照组(P<0.05)。观察组术后48 h内不良反应发生率略低于对照组,但差异无统计学意义(P>0.05)。结论:与术后舒芬太尼和氟比洛芬酯PCIA相比,结直肠癌根治术后联合右美托咪定PCIA镇痛、镇静效果更好,且有可能减少不良反应。Objective To investigate the efficacy and safety of sufentanil combined with flurbiprofen axetil(FPA) and Dexmedetomidine(DEX) for patient-controlled intravenous analgesia(PCIA) in patients underwent radical resection of colorectal cancer. Methods Randomly divided 80 colorectal cancer patients to be received scheduled radical resection in authors' hospital(2019-01-2022-09) into control group(40 cases, PCIA with sufentanil and FPA) and observation group(40 cases, instead of sufentanil, FPA,and DEX for PCIA);then, compared both groups' following items: VAS ratings when cough at different time-points within 48 hrs after surgery, Ramsay sedation ratings;within 24 hrs. after surgery PCIA pump's effective impression times, sufentanil dosage;as well as unward reaction incidence status within 48 hrs. after surgery. Results In the VAS ratings when cough at 4,8,12 and 24(h) after surgery observation group was significantly lower than control group(P<0.05),but at 48(h),there was no statistical difference between the two groups(P<0.05);in the Ramsay sedation ratings at 4,8(h) after surgery observation group was significantly higher than control group(P<0.05),but at 4,8,12,24 and 48(h),there was no statistically difference between the two groups(P<0.05);within 24 hrs. after surgery the PCIA pumps' effective impression times and sufentanial dosage observation group was significantly less than control group(P<0.05);though the unward reaction incidence within 48 hrs. after surgery observation group was slightly lower, but had no statistical difference than control group(P<0.05). Conclusion After surgery(sufentanial+FPA+DEX) PCIA has more better sedation efficacy than(sufentania+FPA) PCIA,and could decrease unward reaction happening.

关 键 词：结直肠癌 术后 病人静脉自控镇痛 右美托咪定 舒芬太尼 氟比洛芬酯 效果 

分 类 号：R614[医药卫生—麻醉学] R735.34[医药卫生—外科学]